Disability and Medical Coverage: A Resource

Disabled individuals often lack access to health insurance, medical coverage and/or prescription coverage. When dealing with an application for Social Security Disability Insurance, medical treatment and compliance with doctor’s orders, such as taking certain medications on a regular regiment, can be critical to proving a disability exists. Where then can disabled individuals turn for assistance in obtaining their necessary medications and access to doctors when they have little to no income?

Most states offer some form of insurance or assistance for medical treatment and/or prescription needs. In the State of Wisconsin, many low income households turn to the BadgerCare program to meet their health insurance needs. BadgerCare provides health insurance to low-income, uninsured families with children under the age of 19 who are not eligible for Medicaid and who are uninsured. For more information on eligibility requirements, a representative can be reached at the BadgerCare customer service at 800-362-3002.

For individuals who have lost health coverage with their employer or are unable to find affordable coverage in the private market due to their medical conditions, there is the Health Insurance Risk Sharing Plan (HIRSP). Applicants are required to meet HIRSP eligibility criteria to qualify. More information on the eligibility requirements and details about these plans can be found at http://www.hirsp.org/ or 800-828-4777.

Medical treatment often involves prescription drugs, which can be costly. There are however a number of avenues by which an individual can seek reduced or even free prescription drugs. First of all, many drug manufacturers often offer discounts and even free prescription drugs for certain types. Contact the drug manufacturer directly to inquire about assistance. A national organization called Partnership in Drugs also offers discounts, coupons, annual reduction and even free medication for select drugs. For more information contact them at 800-477-2669.

Wisconsin offers information and assistance ordering prescription drugs from reputable and researched pharmacies from other countries. The goal is to educate consumers on available options such as local pharmacies, lower cost generics, safe Canadian pharmacies and through a pharmacy benefit manager who will find the lowest price from several countries, allowing consumers to make an informed, safe choice. More information can be found at http://www.drugsavings.wi.gov/.

Finally, there is the BadgerRx Gold Program for individuals without health insurance or individuals with health insurance but no prescription drug benefit, in a plan with high coinsurance or in a plan that does not cover the individual’s prescription. BadgerRx Gold is not insurance and does not coordinate with other insurance plans, but does offer savings on covered medications at participating pharmacies. There is an annual fee for participation in this program. For a list of covered medications and additional information on the BadgerRx Gold Program visit http://badgerrxgold.com/.

Attorney Allen is an associate attorney of Alan C. Olson & Associates, s.c. If you have questions regarding social security disability benefits, please feel free to contact her at: [email protected]


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